As the emission regulations get more and more stringent in the different fields of energy and environmental systems, the electric and fuel cell vehicles (FCV) have attracted growing attention by automakers, governments, and customers. Research and development efforts have been focused on devising novel concepts, low-cost systems, and reliable electric/fuel cell powertrain. In fact, electric and fuel cell vehicles coupled with low-carbon electricity sources offer the potential for reducing greenhouse gas emissions and exposure to tailpipe emissions from personal transportation. In particular, Pedal Assisted Bicycles (PAB) popularity is rising in urban areas due to their low energy consumption and environmental impact. In fact, when electrically moved, they are zero emission vehicles with very low noise emissions, as well. These positive characteristics could be even improved by coupling a PAB with a fuel cell based power generation system, thus increasing the vehicle autonomy without influencing their emissions and consumption performances. In this paper, four types of vehicles are compared from an environmental and accessibility point of view: conventional car, bus, electric PAB and hydrogen fuel cell PAB; for such vehicles, the respective utilization stages are accounted for, i.e. without considering the manufacturing process. The analysis has been carried out comparing different vehicles performance along different routes of an Italian middle-size city, Viterbo, which represents a very good pilot case as its Municipality is adopting many solutions suggested by European Union (EU) through the planning tool called Sustainable Energy Action Plan (SEAP). The comparison is based on an ad-hoc developed mathematical procedure, which includes environmental (greenhouse gas and air pollution emissions), health (pollutants toxicity levels) and accessibility time (waiting times) indicators. According to this analysis, electric and fuel cell PAB exhibit interesting advantages over the other vehicles. However, the global economic efficiency of electric or fuel cell apparatus depends substantially on the exploited source of electrical energy.